- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.91 / $25.70 / $144.54
| Facility | | $8.91 | $25.70 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $7.94 / $38.90
| Professional | | $5.01 | $7.94 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.13 / $12.59 / $100.00
| Facility | | $8.13 | $12.59 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $8.91 / $18.62
| Professional | | $5.25 | $8.91 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.78 / $22.39 / $34.67
| Facility | | $17.78 | $22.39 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $8.32 / $11.22
| Professional | | $8.32 | $8.32 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.92 / $14.13 / $34.67
| Facility | | $6.92 | $14.13 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.46 / $10.72 / $14.79
| Professional | | $6.46 | $10.72 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $3,630.78 / $9,772.37
| Facility | | $12.59 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.18 / $13.18 / $15.49
| Professional | | $13.18 | $13.18 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $8.91 / $26.30
| Professional | | $8.91 | $8.91 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.33 / $22.39 / $39.81
| Facility | | $9.33 | $22.39 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.13 / $12.59 / $100.00
| Facility | | $8.13 | $12.59 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $8.91 / $18.62
| Professional | | $5.25 | $8.91 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.13 / $8.91 / $14.45
| Facility | | $5.13 | $8.91 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.47 / $7.24 / $20.89
| Professional | | $4.47 | $7.24 | $20.89 |